Rehabilitation After Distal Radius Fracture: Common Concerns and Questions

Rehabilitation for Distal Radius Fracture of the Right Hand

Hello Doctor, I had a follow-up appointment in the seventh week after my fracture.
After the X-ray, the doctor said that I basically don't need to wear a wrist brace anymore and started to help me with forearm supination movements.
However, I experience pain in my ulna.
The doctor asked if the pain was due to my resistance or if it was genuine pain.
There was also pressure on the ulna (on the outer side), which is indeed painful.
The doctor didn't elaborate much, so I would like to ask a few questions.

First: Is the pain in my ulna related to the pressure from the wrist brace being applied on top of it?
Second: Could it be that the ulna is still not fully healed? However, the diagnosis was only a radial fracture.

Third: The forearm supination feels stiff and painful; is this due to stiffness or is there another reason?
Fourth: Will the pain in the ulna resolve on its own?
Fifth: The doctor said I could stop wearing the wrist brace and provided me with some rehabilitation exercises to do at home.
Is it really okay to stop wearing it? Shouldn't recovery from a fracture take at least three months for optimal healing?
I would appreciate it if you could answer my questions one by one! Thank you!

Wu, 20~29 year old female. Ask Date: 2022/12/01

Dr. Shi Guozheng reply Orthopedics

A radial fracture typically begins to heal within six weeks, but it may take over three months for the bone to become sufficiently strong.
During this period, pain may still be present, and rehabilitation can be performed to improve or alleviate discomfort.

Reply Date: 2022/12/01

More Info

Rehabilitation after a distal radius fracture can be a complex process, and it's understandable that you have several concerns regarding your recovery. Let's address your questions one by one.

1. Ulnar Pain and Wrist Brace: The pain you're experiencing in the ulnar area could indeed be related to the pressure from the wrist brace. If the brace is too tight or positioned incorrectly, it can cause discomfort or pain in the surrounding areas, including the ulnar side of your forearm. It's essential to ensure that any supportive devices are fitted correctly and adjusted as needed to avoid unnecessary pressure on sensitive areas.

2. Incomplete Healing: While your doctor has diagnosed you with a distal radius fracture, it's important to remember that the healing process can vary significantly from person to person. Even if the fracture is healing well, the surrounding soft tissues, including ligaments and tendons, may still be recovering. Pain can persist if there is inflammation or if the tissues have not fully healed. If you continue to experience pain, it may be worth discussing with your doctor whether additional imaging or evaluation is necessary to rule out any complications.

3. Forearm Rotation Pain: The discomfort you're feeling during forearm rotation could be due to stiffness in the joint or surrounding tissues. After a fracture, it's common for the joints to become stiff due to immobilization. This stiffness can lead to a sensation of "catching" or pain during movement. Engaging in gentle range-of-motion exercises, as advised by your healthcare provider, can help improve flexibility and reduce discomfort over time.

4. Natural Resolution of Ulnar Pain: Ulnar pain can improve naturally as the healing progresses and as you continue with rehabilitation exercises. However, if the pain persists or worsens, it is crucial to follow up with your healthcare provider. They may recommend physical therapy or other interventions to address the pain and improve function.

5. Wrist Brace and Rehabilitation: Your doctor’s recommendation to stop using the wrist brace suggests that they believe your fracture is stable enough to begin more active rehabilitation. While it is true that fractures typically take around three months to heal fully, the timeline can vary. Your doctor likely feels confident that you can start rehabilitation exercises without the brace, but it's essential to listen to your body. If you experience significant pain during exercises, it may be wise to revert to using the brace temporarily and consult your doctor for further guidance.

In summary, rehabilitation after a distal radius fracture involves careful monitoring of pain, mobility, and function. It's essential to communicate openly with your healthcare provider about your symptoms and progress. If you have ongoing concerns about pain or the healing process, don't hesitate to seek further evaluation or a referral to a physical therapist who can provide specialized care tailored to your needs. Remember, the goal of rehabilitation is not only to heal the fracture but also to restore full function and minimize any long-term complications.

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